Reality Strikes

The May 14 issue of the New England Journal of Medicine contains an article, Picking the Right Poison — Options for Funding Health Care Reform, that sets a new tone for the journal. It looks at health care reform through a clear lens. Funding universal health care is going to cost a lot of money. Be assured that whatever the estimate of its cost now is, its true cost will be many multiples of whatever number is currently presented.

Jonathan Oberlander the author of the perspective piece rightly concludes that health care reform cannot pay for itself by making the system more efficient. Rather expansion of coverage will generate additional costs. Raising taxes seems inevitable, hence picking the right poison. This choice usually means taxing someone else.

Reducing benefits is another option. This, of course, will be presented as getting rid of fat. One man’s meat is another man’s fat. Oberlander’s statement, “There is, then, no easy way to pay for comprehensive health care reform,” may get him thrown out of the club of right thinking analysts for whom nothing good is hard.

He compounds his truth telling by adding that “reformers may have to retreat from the goal of providing all Americans with comprehensive insurance.” That such a radical approach to healthcare reform made it into the NEJM suggests that hard reality may be intruding on good intention, that intent and outcome are not the same.

Comprehensive!! Universal!! By what definition?? Funding the whims of octomoms, hypochondriacs, illegal aliens. Maybe I am simple minded but I see great opportunities for abuse from all sides. In life one can’t have everything. Without insurance I survive quite well. With insurance I got into big trouble as I trusted the doctors’ recommendatios (which might have been ok for someone else, but not me). Thus causing extensive medical bills. Same with my husband who died. So tiny problems caused massive expense needlessly because of the passion for pharmaceuticals. I see this multiplied expotentially with “universal health care.” And this is only my myopic point of view.

About Neil Kurtzman

Neil A Kurtzman MD is the Grover E Murray Professor Emeritus and University Distinguished Professor Emeritus, Department of Internal Medicine at Texas Tech University Health Sciences Center in Lubbock. He has combined careers in clinical medicine, education, basic research, and administration for more than 30 years.